Advancements in Bioidentical Hormone Replacement Therapy


Bioidentical Hormone Replacement Therapy (BHRT) has garnered significant attention in recent research, revolutionizing hormone therapy with its personalized and precise approach1. This article delves into the latest news and scientific developments surrounding BHRT, shedding light on its numerous benefits for individuals seeking hormone balance.

The Bioidentical Advantage

Bioidentical hormones are structurally identical to those naturally produced by the body, setting BHRT apart from synthetic hormone replacements2. This inherent similarity allows for a more seamless integration into the body’s hormonal pathways, reducing the risk of adverse effects and optimizing therapeutic outcomes.

Tailored Precision in Treatment

Recent advancements in BHRT underscore the importance of individualized treatment plans. Clinicians now have access to advanced diagnostic tools, allowing them to precisely assess a patient’s hormonal profile3. This tailored approach ensures that BHRT addresses specific deficiencies, promoting optimal balance without the one-size-fits-all limitations of conventional hormone therapies.

Mitigating Menopausal Symptoms

BHRT has proven particularly effective in alleviating menopausal symptoms. Recent studies4 indicate that personalized BHRT formulations can significantly reduce hot flashes, night sweats, and mood swings associated with menopause. This individualized approach tailors treatment to a woman’s unique hormonal needs, providing relief with fewer side effects.

Cardiometabolic Health Benefits

Emerging research points towards the potential cardiometabolic benefits of BHRT. Studies5 suggest that BHRT may contribute to improved cardiovascular health by positively impacting lipid profiles and reducing the risk of metabolic disorders associated with hormonal imbalances. Further exploration in this area may unveil additional avenues for utilizing BHRT in preventive medicine.

Cognitive Well-being and BHRT

Recent investigations into the cognitive effects of BHRT have shown promise in supporting brain health. Preliminary findings6 suggest that BHRT may have a positive impact on cognitive function, potentially reducing the risk of cognitive decline in aging individuals. Ongoing research seeks to elucidate the mechanisms behind these cognitive benefits.

Cancer Risk and BHRT

The association between hormone replacement therapy and cancer risk has long been a topic of concern. However, recent studies7 exploring BHRT have provided encouraging insights. Current evidence suggests that BHRT, when appropriately prescribed and monitored, may have a favorable safety profile, minimizing the risk of certain cancers associated with traditional hormone replacement therapies.


The latest developments in Bioidentical Hormone Replacement Therapy underscore its potential as a transformative approach to hormone balance. From tailored precision in treatment to the mitigation of menopausal symptoms and potential cardiometabolic and cognitive benefits, BHRT is emerging as a multifaceted solution. As ongoing research continues to unravel the intricacies of BHRT, it is becoming increasingly evident that personalized and bioidentical approaches hold the key to unlocking the full spectrum of benefits for those seeking hormone balance and overall well-being.


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Article created by SottoPelle and used by permission of SottoPelle. Advanced Hormone Solutions is a “Certified” SottoPelle provider


How Hormone Therapy May Help Migraine Headaches

Testosterone deficiency and cardiovascular disease in men may be linked. In the United States, heart disease is the top cause of death in men. Heart disease accounts for 1 in 4 deaths for men. However, for men who do have a testosterone deficiency, testosterone therapy may be one safe and effective method of protecting against cardiovascular issues.

Testosterone deficiency in male patients lead to many unpleasant side effects. But physicians across the nation are seeing a correlation between testosterone deficiency and increase risk of serious disease or even death. As studies evolve on the topic of low testosterone and mortality rates, physicians are seeking ways to help their patients achieve more positive outcomes and live longer. Physician hormone replacement therapy (HRT) training helps physicians understand how to dose their male patients to meet their unique needs.

Causes of Testosterone Deficiency

There are many causes of testosterone deficiency in men. As men grow older, testosterone production natural declines. Other causes of decrease in testosterone production include issues such as testicular failure, trauma, and chronic illness.

In a recent study, it was concluded that there is no evidence that testosterone therapy is not related to an increased risk in cardiovascular problems. But there is ample evidence that testosterone therapy does not increase risk.

Many studies support testosterone replacement therapy as a cardiovascular benefit. This is noteworthy because low levels of testosterone are associated with increased risk of cardiovascular disease and death. Men who receive testosterone replacement therapy with a higher concentration see greater improvement in cardiac risk and mortality rates.

Testosterone replacement therapy has additional benefits such as improvement in myocardial ischemia, exercise capacity, and glucose levels.

Testosterone’s Effects on the Male Cardiovascular System

Testosterone has a significant effect on a male’s cardiovascular system. As men age, typically after age 40, testosterone levels will begin to decrease. This decrease is linked to an increase in mortality and cardiovascular risks.

Low testosterone levels put men at a greater risk of developing type 2 diabetes, coronary artery disease (CAD), and metabolic syndrome. Reduced testosterone levels further complicate the prognosis for men with congestive heart failure (CHF) and can lead to higher mortality rates.

Testosterone replacement therapy can improve many of the cardiovascular diseases that older men face. Testosterone therapy is also linked to reduced mortality in men who were previously testosterone deficient.

Testosterone Deficiency and Coronary Artery Disease

Testosterone deficiency may be associated with more severe cases of coronary artery disease (CAD).

A review conducted in 2013 provided supporting evidence that men with lower serum testosterone levels are more likely to develop coronary artery disease. This study also evaluated the severity of CAD in association with testosterone levels in the blood. These studies found that coronary artery disease was more severe in men who reported with lower testosterone levels.

While the sample size on these studies were small, they show promising correlation between higher serum testosterone levels and decreased severity of CAD.

Testosterone Deficiency and Congestive Heart Failure

Testosterone deficiency is found in many cases of congestive heart failure.

As congestive heart failure continues to be studies, there is evidence to suggest it is more than just failure of the heart. Congestive heart failure may involve other pathways such as the endocrine and muscular systems. In a study of 208 men with congestive heart failure, low serum testosterone levels were found in all classes. These reduced testosterone levels are also associated with more serious patient outcomes and increased risk of death.

Testosterone Deficiency and Metabolic Syndrome

Testosterone deficiency has been shown to be linked to metabolic syndrome (MetS). In an observation study, it was found that there is a relationship between total testosterone, free testosterone, sex hormone binding globulin (SHBG) and metabolic syndrome.

The relationship varied across different aspects of MetS but were stronger for abdominal obesity, high triglycerides, and high blood sugar.

Many studies have established that men with type 2 diabetes have lower levels of testosterone compared to men without diabetes. Studies also indicate that men are most testosterone deficient are also at increased risk of metabolic syndrome and type 2 diabetes.

2023 Research Studies on Low Testosterone & Cardiovascular Disease

There were several new research studies conducted in 2023 investigating the relationship between testosterone deficiency and cardiovascular disease (CVD) in men.

In 2023 a Cleveland Clinic-Led Trial entitled Testosterone Replacement Therapy and Incident Cardiovascular Events in Men was published in the New England Journal of Medicine1. This large-scale, randomized, double-blind, placebo-controlled trial assessed over 5,000 men with low testosterone and pre-existing or high-risk CVD. They found that testosterone replacement therapy did not increase the risk of major adverse cardiovascular events compared to placebo. This study provided important reassurance regarding the cardiovascular safety of testosterone replacement therapy in this population.

Also in 2023, the Danish Registry Study published in the JAMA Network Open2 analyzed data from over 120,000 men with type 2 diabetes. They found that lower testosterone levels were associated with an increased risk of myocardial infarction (heart attack), highlighting the potential link between testosterone deficiency and heart health in this population.

Additionally, a 2023 review of various clinical trials and observational studies published in the Sexual Medicine Review summarized the evidence on the relationship between testosterone deficiency and CVD. The authors concluded that there is compelling evidence for a detrimental effect of low testosterone on vascular health and increased risk of CVD in men with hypogonadism.

While these are just a few examples of recent studies on testosterone and CVD – and research in this area is ongoing – it is increasingly evident that low testosterone levels in men present a significant risk factor for the development of cardiovascular disease.

As a SottoPelle Method HRT trained physician you will be better able to assess your patients’ individual CVD risk factors and evaluate the potential benefits of testosterone replacement therapy – based on each patient’s specific circumstances to ensure they receive the appropriate care.

Physician Training for Treating Testosterone Deficiency

Treating testosterone deficiency may not solve or prevent every disease. However, studies support the evidence that testosterone replacement can help to reduce risks of metabolic syndrome, congestive heart failure, and diabetes.

The SottoPelle® Method places an emphasis on treating patients and their individual needs. SottoPelle® Certified Providers are taught how to individually customize dosages for their patients.

Bio-identical hormones, such as pellets used in the SottoPelle® Method, replicate the structure of hormones naturally created by the body. Bio-identical hormones are more effective than pills, patches, or creams. They are also safer for patients, without side effects caused by synthetic hormone replacement therapy methods.

Call 201-225-2525 or schedule a consultation at:

Article created by SottoPelle and used by permission of SottoPelle. Advanced Hormone Solutions is a “Certified” SottoPelle provider


How Hormone Therapy May Help Migraine Headaches

The relationship between hormones, particularly hormonal decline or deficiency, and migraine headaches is a complex and multifaceted area of study within the fields of neurology and endocrinology. Migraines, which are severe headaches often accompanied by other symptoms like nausea and sensitivity to light, affect a substantial portion of the population, and their connection to hormonal fluctuations has been widely investigated.

According to the Migraine Research Foundation, migraine is the 3rd most prevalent and 6th most disabling disease in the world.1 A World Health Organization report in 2018, an estimated 1 billion people worldwide suffer from migraines, making it one of the most common neurological disorders.

And in 2023 the American Migraine Foundation estimated that 39 million people in the United States, or 15.1% of the adult population, experience migraine headaches. Also in 2023, The Migraine Research Foundation emphasized that migraines can significantly impact quality of life, causing missed workdays, reduced productivity, and social limitations.

In this article the hormone replacement experts at SottoPelle Method explore the connections between hormones and migraines.

Who Gets Migraine Headaches

While migraine symptoms can start as early as age 5, they typically present with different triggers compared to adults, according to the American Migraine Foundation. Much more commonly, migraine headaches typically begin in adolescence or early adulthood, with peak prevalence between the ages of 25 and 55, per the National Headache Foundation.

And the prevalence of migraines decreases after 55 years old, but the condition can still persist in older adults. As with any disease or disorder, early diagnosis and treatment are crucial for managing migraines effectively and improving patients’ quality of life.

Migraine headaches are more common in women than men, with a ratio of roughly three to one. In women, fluctuations in estrogen levels, especially during the menstrual cycle, pregnancy, and menopause, are often linked to migraines. For many women, migraines tend to coincide with specific phases of the menstrual cycle, particularly the drop in estrogen levels just before menstruation begins. This has led to the term “menstrual migraines.” Similarly, during perimenopause and menopause, when estrogen levels decline more permanently, some women may experience changes in the frequency and intensity of migraines, as well.

It is commonly accepted that genetics play an important roles in who is predisposed to getting migraines. And environmental influences are also well known to “trigger” migraines. Certain foods, alcohol, perfumes or fragrances, are common migraine triggers – as are stress, lack of sleep, dehydration and other lifestyle issues.

The Hormone / Migraine Connection

However, the precise mechanisms underlying the connection between hormones and migraines are not fully understood. But the fact that there is a correlation between the onset and decline of migraines and hormonal events such as adolescence, menstrual cycles, and menopause, have led researchers to believe that there may be a strong hormonal component involved in migraines.

It is believed that estrogen plays a role in regulating pain perception and modulating neurotransmitters in the brain. So, when estrogen levels fluctuate, it may trigger changes in blood vessels and neurotransmitters, contributing to the onset of migraines.

In men, although the relationship between hormones and migraines is less studied, some evidence suggests that imbalances in testosterone and other hormones could also play a role. Testosterone deficiency, for example, has been implicated in certain types of headaches.

And, various hormonal treatments, including birth control methods as well as hormone replacement therapy (HRT) for women going through menopause, have been shown to affect migraine headache frequency – further indicating that there is a strong hormone / migraine connection.

Treating Migraines with Hormone Therapy

Women have been telling their doctors for many years, that their migraines coincide with their menstrual cycles and that they seem to get worse during perimenopause and menopause. Unfortunately, these concerns often fell on deaf ears because medical research simply wasn’t abundant enough to back them up. The good news is that science is finally catching up.

Hormonal changes in women are a frequent trigger for those susceptible to migraine attacks. This happens when estrogen levels drop during the menstrual cycle and menopause, or when they fluctuate wildly as they do in perimenopause. A review of current literature published in 2014 found that: 1) women were more likely than men to suffer from migraines; 2) that considerable evidence supports an important role for sex hormones, and 3) that women’s migraines tended to be precipitated by drops in estrogen concentrations, and minimizing this decline may prevent these headaches.2 In fact, proper hormone treatment has been found to help reduce the incidence of migraines for women both before and during menopause.3

Another study reported in 2009 showed that maintaining stable estrogen levels in menopausal women with a history of migraines markedly reduced the incidence of these headaches.4 In this and other studies, the use of non-oral, bioidentical forms of estradiol delivery helped achieve maximum results. This was due to the ability of those methods to deliver a steady, consistent dose of hormone.

It’s important to note that these studies also found that synthetic estrogen and oral forms of the hormone can actually worsen migraines. This is because these methods of hormone delivery simply can’t produce stable, dependable hormone levels around the clock, like subdermal BHRT pellets do.

Estradiol Hormone Therapy for Migraines

The best results have been achieved using estradiol under-the-skin (subdermal) pellets,5 which provide steady, 24/7 doses of hormone for months at a time. Early research (1974) by Greenblatt demonstrated that both menstrual and postmenopausal migraine could be controlled with subcutaneous hormone pellets.6 That study concluded that estrogen pellets alleviated all symptoms in the majority of his menopausal patients, and that maintenance of stable estrogen levels would control menopausal migraine.

For years, Dr. Gino Tutera, BHRT pioneer and the founder of SottoPelle® Method, used bioidentical estradiol pellets to treat hormone deficient women of all ages who suffered from migraines. A 90 percent success rate was achieved with this approach. Estrogen levels were restored for these patients within three to seven days and their headaches were either reduced significantly or eliminated.

Migraine Headache Hormone Therapy

Understanding the interplay between hormones and migraines is crucial for developing targeted treatments. Hormone therapies, lifestyle modifications, and other interventions can be combined in a comprehensive treatment plan to manage migraines more effectively, especially in individuals whose headaches are influenced by hormonal fluctuations.

However, due to the complexity of these interactions, personalized approaches by a trained hormone therapy specialist are recommended for a comprehensive assessment and tailored migraine treatment plan.

If you are suffering from migraines and have been unsuccessful in treating them with other methods, the issue may be your hormones.

Call 201-225-2525 or schedule a consultation at:

Article created by SottoPelle and used by permission of SottoPelle. Advanced Hormone Solutions is a “Certified” SottoPelle provider


How Natural Estrogen Replacement Therapy Treats Osteoporosis

For many women, the decline in estrogen production that occurs due to menopause causes very visible and frustrating side-effects. These can include hot flashes, mood swings, hard-to-lose belly fat, insomnia, and more. But a much more dangerous consequence of menopausal hormone decline remains invisible:  the weakening of a woman’s bones or “osteoporosis”.

Estrogen, while primarily thought of as a “reproductive hormone,” is also essential to maintaining strong, healthy bones. As estrogen levels decline during menopause, the bones lose calcium. This puts a woman at serious risk of one or more broken bones. In fact, a full fifty percent of women over the age 50 will suffer a bone fracture because of osteoporosis!

And, since osteoporosis has no obvious external symptoms, many women do not even realize that they have it until they experience a fracture.

The good news is that osteoporosis can be prevented in women nearing or during menopause, through the use of 100% natural, convenient and safe bioidentical estrogen replacement therapy.

Preventing Osteoporosis with Natural Estrogen Replacement Therapy

To begin with, it is helpful to understand how proper hormone balance protects bones.  One of estrogen’s many functions is to stimulate activity in certain cells – called “osteoblasts” – that produce bone. So, when a woman’s estrogen level drops due to menopause, these osteoblasts no longer produce new bone cells, and the bones become more “hollow” or porous and weaker.

The very first FDA treatment that was approved to prevent osteoporosis was actually estrogen replacement therapy! Subsequently, pharmaceutical companies have jumped on the osteoporosis bandwagon, offering a variety of synthetic drugs and medications to improve bone density. These include bisphosphonates (like Fosamax and Boniva) and anabolic drugs. But, as with any lab-created drug, osteoporosis medicines come with a wide array of side effects.

So, while there are now many new synthetic drugs for osteoporosis, most enlightened medical professionals prefer to treat the underlying cause of osteoporosis – estrogen deficiency – in order preserve bone density and prevent bone fractures in post-menopausal women. But just replacing estrogen with a one-size-fits-all synthetic hormone pill or cream isn’t the best answer.

The Two Types of Estrogen Replacement for Osteoporosis

There are two types of hormone replacement therapy: synthetic hormones created in a laboratory, and “bioidentical” replacement hormones that are derived from natural, plant-based sources.

Nothing that is created in a lab will ever be identical to what is found naturally in the body. But “bioidentical” hormones that are obtained from natural, living, plant-based sources are virtually identical in molecular structure to human hormones. So, the human body more readily “recognizes” bioidentical hormones, and they “fit” better with the body’s other cells. As a result bioidentical hormones – such as SottoPelle® Method estrogen replacement using subdermal pellets – are more effective than lab created hormones.

Bioidentical Estrogen Replacement is Safer for Osteoporosis

Because bioidentical hormone replacement therapy replicates the hormones that the body naturally produces, bioidentical estrogen replacement therapy is very safe for most perimenopausal, menopausal or post-menopausal women. The esteemed American Society for Reproductive Medicine, The North American Menopause Society, and The Endocrine Society have all unequivocally stated that most healthy, menopausal women can safely use estrogen replacement therapy for osteoporosis prevention.

(Note: A very small number of women with certain health issues – including women with breast or uterine cancer, liver disease, or a history of blood clots – may not be ideal candidates for estrogen therapy.  Estrogen replacement therapy Your doctor or a SottoPelle Method Certified Physician can help you decide if estrogen therapy is right for you.)

Ideally, the best time to begin estrogen replacement therapy for osteoporosis prevention is during early menopause. But, clinical studies have also demonstrated that estrogen replacement therapy can still preserve and protect bone mass, even when started more than a decade after the onset menopause!

Clinical Studies on Estrogen Replacement & Osteoporosis

A systematic clinical review entitled Bioidentical Hormone Replacement Therapy and Quality of Life in Postmenopausal Women was published this year (Maturitas; April 2023) found that bioidentical hormone replacement therapy significantly improved bone density in postmenopausal women. The study authors concluded that BHRT was an effective treatment for osteoporosis prevention.1

A study in the American Journal of Medicine also found that women receiving BHRT had a slower rate of bone loss compared to those not using hormone therapy – recognizing estrogen replacement therapy for its positive impact on bone mineral density and fracture prevention.

The esteemed American Society for Reproductive Medicine, The North American Menopause Society, and The Endocrine Society have also all unequivocally indicated that most menopausal women can safely use estrogen replacement therapy for osteoporosis prevention.

Pellets: The Best Estrogen Replacement Method

Estrogen replacement was originally delivered by a wide variety of methods: daily pills, messy gels and creams, unsightly patches, and painful shots. But SottoPelle® has “changed the game” of female hormone replacement with long-lasting, time-released sub-dermal estrogen pellets, that last from 3 to 5 months with a single insertion.

To begin with, estrogen pellets are much more convenient to use – with nothing to remember to take every day, no patches to replace, no sticky creams to apply, and no painful shots.

Even more importantly, hormone replacement pellets are by far more effective that other estrogen delivery methods. Clinical studies have shown that use of estrogen pellets resulted in four times the increase in bone density of oral estrogen pills, and 2.5 times more bone mass than hormone patches!

Additionally, unlike hormone pills, shots, or creams that put your body on a roller coaster of hormone dosage ups and downs, time-released estrogen pellets deliver hormones the same way the ovaries do – consistently and gradually over time, only as they are needed.

Estrogen Replacement Therapy

Bioidentical estrogen replacement therapy prevents osteoporosis by restoring the body’s natural hormone balance – rather than introducing lab-created chemicals that come with harsh and dangerous side effects.

It’s never too late to take steps to ensure that you are NOT in the 50% of women who will suffer a bone fracture due to osteoporosis. Ask your doctor if estrogen replacement therapy is the right treatment to help you maintain strong, healthy bones after menopause … and for the rest of your life!  Then insist on bioidentical estrogen replacement pellets for the safest, most consistent, 100% natural, and easiest-to-use form of hormone replacement.

Call 201-225-2525 or schedule a consultation at:

Article created by SottoPelle and used by permission of SottoPelle. Advanced Hormone Solutions is a “Certified” SottoPelle provider